The Nutritional and Clinical Impacts of Using NonSelective Beta-Blockers with Enteral and Parenteral Nutritional Formulas in Hospitalized Patients with Severe Wasting Syndromes

Hospitalization associated malnutrition is a type of stress condition that characterizes by hypermetabolism. Such hypermetabolism is accompanied by increased lean body mass (LBM) catabolism and increased basal energy expenditure (BEE). The severity of this hyper-catabolism may be the primary determinant of severe wasting in hospitalized and critically ill patients. This hypermetabolic status can be mitigated partially through the beta-adrenergic receptors in which propranolol can mitigate this hyperdynamic and hypermetabolic status through its non-selective adrenergic antagonist. The aim of this study is to evaluate the clinical impacts of using propranolol as an anticatabolic agent in adjunctive to either enteral or parenteral nutrition provision. Methods: A retrospective analysis was conducted in our institution between April 2017 and April 2019. Discharged or dead patients were excluded if failed to complete at least 1 week after hospital admission. Our sample was stratified into two comparative groups. Group I (Malnourished hospitalized patients who were administered propranolol tab 40 mg TID as an anti-catabolic agent), Group II (Malnourished hospitalized patients who weren't administered propranolol tab). Independent Samples, One-Sample T-test, and Chi square test were used in our study. Results: The mean age of our 188 studied malnourished hospitalized patients was 58.94±10.37 years in which 131 patients (69.7%) of the eligible sample were males and 57 patients (30.3%) were females. Group I had significantly higher average albumin level (ALBavg) than Group II (3.49±0.02 g/dl vs 3.25±0.06 g/dl) with Mean difference±SEM of +0.24±0.01 g/dl. Conclusion: Non-selective beta-blockade with propranolol improves survival in severe malnourished hospitalized patients without evidence of clinically significant hemodynamic compromise Significant higher ALBavg accompanied with lower blood urea nitrogen (BUN) may indicate for propranolol anti-catabolic effect which may have a positive major and minor clinica